News / Health

Patient Cured of HIV Provides Hope for Researchers

Suzanne Presto
WASHINGTON — Timothy Brown, a 46-year-old from the western United States, was once known in medical journals as "the Berlin Patient."  He is the man who had HIV, but doesn't anymore.

Brown revealed his identity in 2010, three years after an innovative treatment battled both the HIV and an acute form of cancer in his body.  He now promotes AIDS research.  

"I do have some mobility problems, but apart from that, I feel great.  Yes, it's great being cured," he said last month in Washington at a policy briefing organized by The Foundation for AIDS Research, or amfAR.   

Doctors say he is the first person to be considered cured of HIV.

"I am functionally cured, which means that I don't have any effects from the virus, and I don't have to take medication against the virus," Brown said.  "And as long as it stays that way, which I'm pretty sure it will, I'm okay with that."

Brown was living in Berlin when he tested positive for HIV in 1995.  He took medications to manage the virus.  More than a decade passed, and he started to feel excessively fatigued.  A bone marrow biopsy in 2006 revealed leukemia.      

After chemotherapy treatments, Brown's oncologist, Gero Huetter, suggested a bone marrow transplant.  

Dr. Huetter knew that 1 out of 100 people, mostly northern Europeans, are highly resistant to HIV due to a genetic mutation.  Simply put, they lack doorways that allow HIV to enter their cells.  

Paula Cannon, an associate professor at the University of Southern California, told the crowd assembled for the amfAR briefing that the HIV-resistant mutation was well known to the small group of medical researchers who specialized in HIV.  She explained that when people with the genetic mutation are exposed to HIV, the virus "has nowhere to go and sort of fizzles out."
 
In 2007, Brown went through total body irradiation and then received a bone marrow transplant from an HIV-resistant donor.  He immediately stopped taking HIV medication.  Although the leukemia returned, the HIV did not.  

"The first transplant went well but the second one was pretty horrible, and I wouldn't wish what I went through on my worst enemy," Brown recalls.  His complications included delirium, and he suffered neurological damage.        

Researchers stress that such transplants are very dangerous for patients and should only be done in extreme circumstances.   

"Tim had it not because he was HIV-positive," Cannon told the amfAR group. "He had it because otherwise he would have died of leukemia."   

Brown, who used to work as a translator and has limited financial resources, says his life is now devoted to providing hope.

"It's kind of hard sometimes, like, dealing with people who still have HIV.  I'm like, I kind of get a guilt feeling because I..." Brown's voice trails off for a moment. "That's basically why I'm going around the world and talking to people.  I want there to be research."

Dr. Robert Siliciano of Johns Hopkins University says Timothy Brown has been tested repeatedly and there is no confirmed evidence of HIV in his system.  Dr. Siliciano acknowledges that there is some controversy about the fact that a few tests suggest trace amounts of HIV in Brown's system.  But the doctor notes the techniques being used can pick up a single molecule, so false positives are a strong possibility.
 
"Also, there's the fact that Tim has been off treatment for five years and the virus has not started to replicate, so I think you're cured," Dr. Siliciano told Brown at the amfAR briefing, prompting Brown to laugh and offer his thanks.   

Dr. Susan Blumenthal, a senior policy and medical adviser for amfAR, says Brown's case has changed the path of cure research.  
 
"It has inspired us to put 75 percent of our research dollars into finding a cure," says Dr. Blumenthal.  "I think he's a courageous person."

Tim Brown says that he was "scared to death" when he was diagnosed with HIV and again when he was diagnosed with leukemia.  

"Somehow I knew in my heart that I would survive, even though the odds were against me," he said.  "I was probably the first patient that they had in the hospital who would work out in the hospital room. I brought equipment to work out with, and I wanted to stay in shape.  I didn't want to lay in bed and give up, so that was probably a large part of it."  

He adds that it is important for very ill people to have somebody to count on, as he did.

Brown's case galvanizes researchers such as Paula Cannon, who uses gene therapy to develop cells with the HIV-resistant mutation.   

"He's really a symbol of what we can do, what we can aspire to, and hope, and oh my goodness, motivation in buckets," exclaims Cannon.

Cannon says scientists are trying to introduce the HIV-resistant mutation into a person's own bone marrow, making it HIV-resistant.  That would eliminate the risks involved with receiving a transplant from a foreign donor.

Cannon's own HIV research involves a special type of mice.  

"We can do a transplant of human bone marrow into these mice and they will grow us a little human immune system.  We can then infect the mice with HIV, and importantly, we can cure the mice of HIV," explains Cannon.  "So, in the mice, we were able to show that we have the tools now to cure them of HIV, and so we're now trying to translate that into the much bigger mammal, the human being."

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